Rita is a 105 pound 19 year-old college student who, as part of a sorority hazing ritual, attempted to drink 2 gallons of water over a 1 hour period. She made it through 1.5 gallons before she began vomiting, became disoriented, and started slurring her speech. Others at the party didn't think much of her behaviors, until she collapsed and began having seizures. 911 was called and she was rushed to the hospital.
In the emergency room, Rita was semi-comatose, responding only to painful stimuli. Her vital signs were stable, and a review of other systems noted no abnormalities. Blood and urine labs were ordered, with the following results:
Na+: 109 mEq/L
K+: 4.0 mEq/L
Chloride: 88 mEq/L
CO2: 20 mEq/L
Blood urea nitrogen (BUN): 9 mg/dL
Creatinine: 1.0 mg/dL
Glucose: 105 mg/dL
Serum osmolality: 229 mOsm/kg H2O
Urine osmolality: 80 mOsm/kg H2O
Questions (1 point each)
1. List Rita's abnormal lab values, along with their normal ranges.
2. What 2 conditions is Rita simultaneously suffering from?
3. What lab values support these diagnoses?
4. This condition can cause brain damage secondary to cerebral edema. Explain, in detail, the mechanism by which cerebral edema occurs in the setting of these diagnoses.
5. What will the treatment be for this patient?